For nearly 40 years, these aides — mostly women, many minorities and immigrants — have been exempted, like teenaged baby sitters. They weren’t entitled to the federal minimum wage or, no matter how many hours they worked, to overtime pay.

In 2007, the Supreme Court found that Evelyn Coke, in wheelchair, was not entitled to overtime pay as a health care aide. [CREDIT: Andrew Councill, for The New York Times]

When Evelyn Coke, an veteran aide from Queens, got fed up and brought a lawsuit that went all the way to the Supreme Court in 2007, the justices unanimously ruled against her, saying this was a matter for the Labor Department. In ill health herself, she died two years later at 74.

The Obama administration vowed to change the Labor Department rules, but the groups lobbying for change — labor unions, AARP, advocates for seniors and people with disabilities, the Direct Care Alliance and other workers’ groups — still had to wait nearly two years for action. Meanwhile, many aides continued to rely on food stamps and Medicaid.

Now that the Labor Department has given home care aides the same protections as other workers, supporters are using words like “historic” and “victory.” In a celebratory conference call with reporters last week, a Virginia aide named Lauralyn Clark, who earns $8.87 an hour, said, “We work hard to give our clients a good quality of life. This way, we will be able to have one, too.”

It was a Norma Rae moment. Yet as I’ve been talking to people since, I’m learning that the immediate effect of the ruling may not be particularly dramatic.

First, the new rules don’t take effect until Jan. 1, 2015, an unusually long delay. “There was enough anxiety expressed by opponents that they decided to give people plenty of time to figure it all out,” said Catherine Ruckelshaus, legal co-director of the National Employment Law Project, a key force in the campaign.

At that point, the rules extend the minimum wage to home care workers. But they are already covered in 21 states and the District of Columbia, and several of those (including California, Washington and Massachusetts) have minimum wages higher than the federal rate of $7.25 an hour. If campaigns to raise the federal wage gain traction, home care aides will of course benefit, but that seems like a long shot at the moment.

(People who hire aides privately, through the so-called gray market, are now also obliged to pay minimum wage and overtime, though there’s no real enforcement mechanism to ensure that they do.)

The more significant change, Ms. Ruckelshaus agreed, will come with overtime. In 2015, an aide who works more than 40 hours for a single employer — either an agency or a private individual — must be paid time and a half thereafter. Only 15 states currently require overtime.

But it’s a change that may not affect large numbers of aides, because they’re primarily part-time workers who often wish they had more hours on the job than they do.

The industry particularly opposed this provision and predicted dire consequences. “Home care companies will have little choice but to employ workers part-time rather than full-time, as Medicaid payment rates and consumers with limited incomes cannot afford higher costs,” the chair of the National Association for Home Care and Hospice said after the Labor Department decision.

But in states that already have overtime regulations, Ms. Ruckelshaus pointed out, “they’re all managing to do it and it’s worked out.” Agencies may hire another worker for a client who needs a great deal of care, but if only a few more than 40 hours are involved, it’s cheaper at these low wages to pay time and a half.

Moreover, the overtime rules don’t cover live-in helpers, though they do require employers to keep better records of the hours worked and to pay at least minimum wage.

Does this mean that after all this time, the new regulations won’t bring much change for most home care aides? Not exactly.

One boost is that these workers will now get paid for their travel time, not just the hours they spend providing care. Deducting the time it takes to go from one client’s home to another often brought a worker’s pay below minimum wage, even in states that supposedly required it. “There’s always this chiseling and backsliding that goes on,” said Ms. Ruckelshaus. “That’s no longer permissible.”

Which leads to the really significant improvement for this workforce: federal oversight. Almost by definition, home care workers are a scattered group, harder to organize (ask the unions that are trying) and to communicate with than employees in a central workplace. They haven’t had much recourse when an employer, either an agency or a private person, keeps them on the job 50 hours a week without overtime pay or fails to pay for travel time, reducing their wages.

So aides have tended to react to poor working conditions, high injury rates and low pay by leaving their jobs, rather than lobbying to improve them. Turnover rates are dismayingly high, a problem not only for workers but for those they assist.

Now, the Fair Labor Standards Act covers home care aides just like their counterparts in nursing homes or hospitals. Federal overseers “are adding themselves as enforcers, and they’re an important one,” Ms. Ruckelshaus said. “As there are more know-your-rights educational materials, workers will feel empowered to ask when there’s something wrong with their pay stub.”

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Last modified: October 2, 2013
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